Rub shoulders with Kerri Barwick MPS (centre) and other members of team PSA at CPC24[/caption]
The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Suzanne Nielsen MPS[/caption]
What you need to know when supplying take-home naloxone.
The national Take Home Naloxone (THN) program enables access to naloxone directly from a community pharmacy at no cost and without a prescription to anyone who is at risk of an opioid overdose or adverse reaction, and to their carers, friends and family members.1 In its pilot phase ‘three lives were saved each day’, and it is expected that an even greater impact will be seen with the national rollout.2
What should you do to ensure naloxone is supplied and used appropriately?
Have a conversation
Identify and initiate a conversation with patients who are at high risk of opioid overdose.2 The risks associated with opioid medicines should be discussed, and information provided about the role of naloxone in emergency treatment of known or suspected opioid overdose or an adverse reaction. Patients who are at high risk should be encouraged to keep an emergency supply of naloxone on hand, where appropriate.2
Counsel and demonstrate
Naloxone for opioid overdose is available in three forms.2 For this reason it is vital that correct administration technique is demonstrated for the dosage form supplied to the patient and/or the third party.2 Inform the patient that it is likely the third party will administer the naloxone, as the patient will probably be too unwell to self-administer.2
An opioid overdose response plan should be provided alongside naloxone supply, and it should be established that the patient and/or third party understands the plan and how to administer naloxone.2
Lack of information is no reason to withhold supply
Every effort should be made to gather sufficient information to assess the safety and appropriateness of naloxone for the patient.2 However, pharmacists should be aware that barriers to open communication can exist with some atrisk patients (e.g. stigma associated with the use of illicit drugs). Supply of naloxone should not be denied on the basis of insufficient information, as naloxone can be lifesaving.2
References
1. Australian Government, Department of Health and Aged Care. 2022. About the Take Home Naloxone Program. At: www.health.gov.au/initiatives-andprograms/take-home-naloxone-program/about-thetake-home-naloxone-program
2. Pharmaceutical Society of Australia. “Naloxone program will save lives” – Pharmacists welcome rollout. 2022. At: www.psa.org.au/naloxone-programwill-save-lives-pharmacists-welcome-rollout/
Further information
Australian Pharmaceutical Formulary non-prescription medicine guideline, Naloxone for Opioid Overdose, at: https://my.psa.org.au/s/article/Naloxone-for-opioid-overdose
AMBER DOMBERELLI BPharmaceutSc, MPharm, MMedRes, GradCertAppPharmPrac, JP, MPS is a pharmacist in PSA’s Policy team and a PhD candidate.
